Position on Healthcare

[Suburbia]

My ideal system would combine Medicaid with universal catastrophic coverage through something like Medicare.

One of my big points of disagreement with the thrust of not just Democratic-aligned public opinion on this subject, but American public opinion in general, is that middle income people should be paying for most of their health care out-of-pocket. The aim of health care reform should be to construct a health care system in which those expenses are not outrageously high for the typical family.

Unfortunately, I don't think that the "health care system" can be reformed in the United States. It's going to take a catastrophe or the emergence of an alternative to undermine its grip on this country.

For whatever reason, the current US system is highly stable.  Obamacare passed and survived court challenges by the skin of its teeth.  Pretty much every other presidential administration since LBJ has had a reform proposal go nowhere.  It's also remarkable that COVID didn't make health care a major election issue.   

America's health care system needs to be revamped, period.

[beesley]

I support the NHS. Any private involvement doesn't work. As soon as it starts to serve something else (i.e., private profit) it ceases to be a public service. And the way it works best is through strong public health and a strong economy.

[Clarko95 📚💰📈]

I have now experienced the American, Swedish, and German healthcare systems for both general and specialized care (rheumatology, specifically). I can't really express a preference between Germany or Sweden, since both have had their ups and downs (obviously both are better than whatever we have right now in the U.S.), but I have found specialist care to be much better in Germany compared to Sweden so far. General care was about the same. Not sure how much of this is related to the financing versus cultural mentality of how specialist care should be.

Anyways, for the U.S., I think people are just fundamentally too individualistic and suspicious of the government to go for a full UK-Sweden-Italy-style healthcare system, and even a Canada/Australia-style system might be a stretch.

Harry Truman actually did propose a health insurance system that would have functioned somewhat similarly to the continental European model of insurance funds paid for by a 4.5% payroll tax back in 1946: https://www.milkenreview.org/articles/harry-trumans-radical-health-care-plan

Every wage-earning American would receive comprehensive insurance. Patients could choose their doctors. Physicians would not become government employees, but the government would set reimbursement rates, which would incentivize them to practice in rural and low-income areas. Preventive care would be emphasized. And here’s a big one: money from the funds collected to pay for the system would also be used to replace income lost by individuals when ill or injured.

But this wasn’t all.

Truman appealed to Congress to enact legislation to expand medical schools and provide financial aid to low-income medical students. Next, the federal government should help fund the construction of new hospitals and clinics “in communities where they are needed.” He continued: “We should improve the public health preventive and disease control services, which are now inadequate in most areas and totally lacking in many.”

For every insured person and his family, the. medical care and hospitalization fund would pay for unlimited doctors’ care including specialists, for hospitalization up to 30 days, X rays, and laboratory tests. Dental care, nursing, medicines and drugs would not be paid for. Patients would be free to choose their physicians from among those participating in the program, whether engaged in individual or group practice. Standards of competence for specialists and hospitals would be established by the Surgeon General of the United States Public Health Service. Any licensed physician could participate in the program as a general practitioner.

The national fund would pay physicians for the services rendered to patients covered by the system through any of several methods-fee-for-service, capitation, part-time or full-time salaries, or by a combination of these methods. The physicians of each area would choose by majority vote the method of payment to be adopted in that area. Hospitals would be paid up to $6 per day for each day of care they furnished.

Honestly such a damn shame that this didn't happen.

[Crane]

I have now experienced the American, Swedish, and German healthcare systems for both general and specialized care (rheumatology, specifically). I can't really express a preference between Germany or Sweden, since both have had their ups and downs (obviously both are better than whatever we have right now in the U.S.), but I have found specialist care to be much better in Germany compared to Sweden so far. General care was about the same. Not sure how much of this is related to the financing versus cultural mentality of how specialist care should be.

Anyways, for the U.S., I think people are just fundamentally too individualistic and suspicious of the government to go for a full UK-Sweden-Italy-style healthcare system, and even a Canada/Australia-style system might be a stretch.

Harry Truman actually did propose a health insurance system that would have functioned somewhat similarly to the continental European model of insurance funds paid for by a 4.5% payroll tax back in 1946: https://www.milkenreview.org/articles/harry-trumans-radical-health-care-plan

Every wage-earning American would receive comprehensive insurance. Patients could choose their doctors. Physicians would not become government employees, but the government would set reimbursement rates, which would incentivize them to practice in rural and low-income areas. Preventive care would be emphasized. And here’s a big one: money from the funds collected to pay for the system would also be used to replace income lost by individuals when ill or injured.

But this wasn’t all.

Truman appealed to Congress to enact legislation to expand medical schools and provide financial aid to low-income medical students. Next, the federal government should help fund the construction of new hospitals and clinics “in communities where they are needed.” He continued: “We should improve the public health preventive and disease control services, which are now inadequate in most areas and totally lacking in many.”

For every insured person and his family, the. medical care and hospitalization fund would pay for unlimited doctors’ care including specialists, for hospitalization up to 30 days, X rays, and laboratory tests. Dental care, nursing, medicines and drugs would not be paid for. Patients would be free to choose their physicians from among those participating in the program, whether engaged in individual or group practice. Standards of competence for specialists and hospitals would be established by the Surgeon General of the United States Public Health Service. Any licensed physician could participate in the program as a general practitioner.

The national fund would pay physicians for the services rendered to patients covered by the system through any of several methods-fee-for-service, capitation, part-time or full-time salaries, or by a combination of these methods. The physicians of each area would choose by majority vote the method of payment to be adopted in that area. Hospitals would be paid up to $6 per day for each day of care they furnished.

Honestly such a damn shame that this didn't happen.

You can thank the Conservative Coalition, some of whom Truman himself helped keep in power, for that.

[Boobs]

Nationalize medicine, the pharmaceutical industry, and the medical supply industry. It’s the most cost-efficient plan. Psychiatry shouldn’t be nationalized for privacy reasons.

[Damocles]

I’m fortunate enough to have an amazing health insurance plan through my employer. The company pays all of my premiums, the deductibles are reasonable, the copays are low, and there is an FSA as well. But I still want a public option, because this health insurance plan basically makes me the company’s b#%ch. It substantially reduces my mobility in the labor market and my ability to take on better jobs, which might offer more money, but fewer benefits.

[Grumpier Than Uncle Joe]

[GM Team Member and Senator WB]

what are steps 1 and 2?!? This was before my time

[Frodo]

I think Germany and Switzerland are the future of American health care. 

I pay approximately $300 every month on health insurance that I have never once in my life been able to claim on because the insurer only covers costs once I have already spent 2'500 francs in a year. Ok for me, healthy with a decent income; an absolute horror story for someone on a lower income who might have chronic health problems; someone in their old age; someone in one of the cantons where premiums are randomly higher and where the subsidies don't go anywhere near far enough

Almost any serious issue would mean going to a public hospital, covered by tax payer funds, who would bill me for a part of the treatment that even if I sent them it on, the insurer would still wind up essentially subsidised by the cantonal government because they know they can't trust the insurer to cover the full treatment costs for all patients.

The health insurers are, of course, not allowed to make a profit out of selling basic insurance policies, but are allowed to make a benefit - theoretically to cover any unforseen emergencies or pandemics. Curiously, Covid did not actually count as such a pandemic, and the insurers were at no point required to dig into their reserves while the state wound up coverng the full cost of testing, treatment and vaccines.

The Swiss system might be less out and out absurd than the US one, but it isn't a coincidence that it is the one European country where the fundamental nature of the way the system is run is a mainstream debate. It is the most expensive European system by far, and is only kept above water because the federal and cantonal governments spend so much of their time stepping in to to cover the deficiencies of the insurers. In all honesty, it's not an example for anyone.

Okay, point taken.  What's your take on the German healthcare system, though?

[Grumpier Than Uncle Joe]

what are steps 1 and 2?!? This was before my time

I have no clue but this was funny as hell so I saved it in the gallery. 

[Utah Neolib]

Medicare for All is actually a good idea

[GM Team Member and Senator WB]

what are steps 1 and 2?!? This was before my time

I have no clue but this was funny as hell so I saved it in the gallery. 

I found it.

1) Don't get sick
2) if you do get sick...
3) Die quickly

[It’s so Joever]

Anti. /s

[Spark]

We need a public option where the government can compete with private insurers. I believe this is the best option for consumers because it ensures competition and better quality care that people can shop around for.

[Person Man]

The ACA is working now that it’s properly funded. The rule is that no household should pay a premium greater than 7% of their income and no more than 10% in total healthcare expenses.

I would be OK with either this as a way to subsidize middle class insurance or just go with a public option that sells at that price.

[CEO Mindset]

Nationalize medicine, the pharmaceutical industry, and the medical supply industry. It’s the most cost-efficient plan. Psychiatry shouldn’t be nationalized for privacy reasons.

based and redpilled.

both psychology and psychiatry should definitely be scaled back a TON for sure. both are bad because they enable society to keep getting worse and worse by "fixing" individuals into accepting horrible things happening to them.

definitely get therapists out of schools and ban courts from mandating therapy at minimum. just let people buy their hrt otc wherever.